Ultrasound-Guided Comparison of Three Techniques for Prostatic Abscess Drainage: A Retrospective Single-Center Study

A prostate abscess (PA) is a serious condition, yet standardized guidelines for drainage methods remain lacking. This study aims to compare the outcomes of three techniques for PA drainage: transrectal ultrasound (TRUS)-guided aspiration (TRA), transurethral de-roofing (TUD), and transperineal aspiration (TPA). We conducted a retrospective analysis of 66 patients diagnosed with PAs between 2014 and 2022, categorizing them into three groups based on the drainage technique used. Group A consisted of 26 patients treated with TRA, Group B included 28 patients treated with TUD, and Group C comprised 12 patients treated with TPA. We compared the groups regarding demographic data, drainage success, recurrence rates, complications, and hospital stay duration. The most prevalent clinical symptom was lower urinary tract symptoms (LUTS), observed in 45 patients (68.18%), followed by fever in 40 patients (60.6%). The mean abscess sizes were recorded at 4.8±1 cm in Group A, 5.7±1 cm in Group B, and 5.4±1.3 cm in Group C. Recurrence rates were noted as follows: three patients (11.5%) in Group A, one patient (3.6%) in Group B, and one patient (8.3%) in Group C (p=0.496). The average hospital stay was similar among the groups: 4.8±1.7 days for Group A, 5±1.8 days for Group B, and 4.5±1.3 days for Group C (p=0.763). Notably, the TUD group exhibited a higher complication rate of 32.1%. TRUS-guided TRA and TPA demonstrated outcomes comparable to those of the TUD technique concerning recurrence rates and hospital stay duration. However, TRA and TPA were associated with fewer complications, suggesting they may be preferable options for managing prostate abscesses.